hilst its upper part is still continuous with
the fascia transversalis. When the hernia ruptures the saphenous side of
the canal, the fascia propria is, of course, absent.

[Illustration: Abdomen, showing bone, blood vessels
and other internal organs.]
PLATE 45.--FIGURE 6

PLATE 46, Fig. 1.--The anatomical circumstances which serve for the
diagnosis of a femoral from an inguinal hernia may be best explained by
viewing in contrast the respective positions assumed by both complaints.
The direct hernia, 13, traverses the inguinal wall from behind, at a
situation corresponding with the external ring; and from this latter
point it descends the scrotum. An oblique external inguinal hernia
enters the internal ring, 3, which exists further apart from the general
median line, and, in order to gain the external ring, has to take an
oblique course from without inwards through the inguinal canal. A
femoral hernia enters the crural ring, 2, immediately below, but on the
inner side of, the internal inguinal ring, and descends the femoral
canal, 12, vertically to where it emerges through, 6, 7, the saphenous
opening. The direct inguinal hernia, 13, owing to its form and position,
can scarcely ever be mistaken for a femoral hernia. But in consequence
of the close relationship between the internal inguinal ring, 3, and the
femoral ring, 2, through which their respective herniae pass, some
difficulty in distinguishing between these complaints may occur. An
incipient femoral hernia, occupying the crural canal between the points,
2, 12, presents no apparent tumour in the undissected state of the
parts; and a bubonocele, or incipient inguinal hernia, occupying the
inguinal canal, 3, 3, where it is braced down by the external oblique
aponeurosis, will thereby be also obscured in some degree. But, in most
instances, the bubonocele distends the inguinal canal somewhat; and the
impulse which on coughing is felt at a place above the femoral arch,
will serve to indicate, by negative evidence, that it is not a femoral
hernia.

[Illustration: Abdomen, showing bone, blood vessels
and other internal organs.]
PLATE 46.--FIGURE 1

PLATE 46, Fig. 2.--When the inguinal and femoral herniae are fully
produced, they best explain their distinctive nature. The inguinal
hernia, 13, descends the scrotum, whilst the femoral hernia, 9*, turns
over the falciform process, 6, and rests upon the fascia lata and
femoral arch. Though in this position the